How much rates vary
Facilitymedian $8 · 10th to 90th $2 to $26Professionalmedian $8 · 10th to 90th $7 to $49
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $8.13 Median $9.55 Typical High $15.85 | Facility | None | $8.13 | $9.55 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.32 | Professional | None | $8.13 | $8.13 | $8.32 |
BCBS Texas Setting Facility Modifier None Typical Low $1.74 Median $4.37 Typical High $8.51 | Facility | None | $1.74 | $4.37 | $8.51 |
BCBS Texas Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Christus Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $15.49 Typical High $25.70 | Facility | None | $8.13 | $15.49 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Lucent Health Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Moda Health Setting Facility Modifier None Typical Low $5.13 Median $9.33 Typical High $40.74 | Facility | None | $5.13 | $9.33 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.59 | Professional | None | $7.24 | $7.24 | $7.59 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $30.20 Typical High $30.20 | Professional | None | $5.37 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $3.24 Median $9.77 Typical High $69.18 | Facility | None | $3.24 | $9.77 | $69.18 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.41 | Professional | None | $7.24 | $7.24 | $7.41 |
Wellpoint Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
14 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $4.07 Median $5.75 Typical High $7.94 | Facility | 52 · Reduced service | $4.07 | $5.75 | $7.94 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.62 Median $2.29 Typical High $3.16 | Facility | 53 · Discontinued | $1.62 | $2.29 | $3.16 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.23 Median $1.74 Typical High $2.34 | Facility | 55 · Aftercare only | $1.23 | $1.74 | $2.34 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.15 Typical High $1.58 | Facility | 56 · Pre-op care only | $0.81 | $1.15 | $1.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.66 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.26 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.83 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $2.45 Median $17.38 Typical High $46.77 | Facility | JZ · No drug discarded | $2.45 | $17.38 | $46.77 |
Moda Health Setting Facility Modifier U8 · State-defined Typical Low $7.08 Median $7.08 Typical High $8.32 | Facility | U8 · State-defined | $7.08 | $7.08 | $8.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 52 · Reduced service | $3.63 | $3.63 | $3.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.48 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.12 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.74 |
Where Texas sits
Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 9th of 51
$8.13
AK $10.72NC $7.24
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.